The healthcare provider (HCP) prescribes methylergonovine for a postpartum client following the birth of her third child.
The client asks the practical nurse (PN), "Why am I getting these tablets? I did not get them with my last babies.”. Which response is best for the PN to provide?
Bleeding with the delivery of this baby is more than expected, and this medication helps contract the uterus.
The HCP routinely prescribes this medication for all women who have had three or more infants.
Methylergonovine is commonly prescribed to help contract the uterus and prevent excess bleeding.
What did the HCP say about the medications during postpartum care?
The Correct Answer is A
Choice A rationale
Methylergonovine is an ergot alkaloid that directly stimulates sustained uterine contractions. This action is crucial in controlling postpartum hemorrhage by compressing blood vessels within the myometrium, thereby reducing blood loss. The observed excessive bleeding with this delivery necessitates intervention to prevent complications like hypovolemic shock. Its pharmacological effect targets smooth muscle receptors in the uterus.
Choice B rationale
Routine prescription based solely on parity (number of previous pregnancies) is not standard medical practice. Methylergonovine is administered based on clinical indication, primarily to prevent or manage postpartum hemorrhage, which is determined by factors like uterine atony or excessive bleeding, not simply the number of previous births. Unnecessary administration can lead to adverse effects.
Choice C rationale
While methylergonovine does contract the uterus and prevent excess bleeding, this response is a general statement. The best response directly addresses the client's current situation and her question about why *she* is receiving it *this time*. It is crucial to explain the specific clinical reason for her individual prescription, which in this context is likely due to the increased bleeding.
Choice D rationale
This response shifts the responsibility back to the client and does not provide the requested information. It fails to address the client's direct question about the medication's purpose in her specific situation. Providing clear and concise information is essential for client education and adherence to the treatment plan.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Washing frequently with mild soap and water is not recommended for umbilical cord care because soap can irritate the delicate skin around the cord stump and potentially delay the natural drying and separation process. Excessive moisture also increases the risk of bacterial colonization and infection, counteracting the goal of keeping the area clean and dry to promote healing and reduce infection risk.
Choice B rationale
Applying baby lotion to the umbilical cord stump is contraindicated. Lotions introduce moisture, which can impede the natural drying and mummification of the cord, prolonging the time until it falls off. Furthermore, lotions contain chemicals that may irritate the sensitive skin or harbor bacteria, increasing the risk of infection and delaying proper healing of the umbilical area.
Choice C rationale
Covering the umbilical cord with a sterile dressing is generally not advised unless specifically indicated by a healthcare provider for a particular condition. A dressing can trap moisture, preventing adequate air circulation needed for drying, and potentially create a warm, moist environment conducive to bacterial growth. This increases the risk of infection and delays natural cord separation.
Choice D rationale
Cleaning the umbilical cord with water and allowing it to air dry is the most evidence-based practice for routine cord care. Water gently removes any discharge without irritating the skin, and air exposure facilitates the drying process, which is crucial for mummification and eventual detachment. This minimizes the risk of infection and promotes natural healing.
Correct Answer is B
Explanation
Choice A rationale
Sweet potatoes are a gluten-free root vegetable. They are rich in vitamins, minerals, and fiber, and their consumption is safe for individuals with celiac disease or gluten sensitivity. The presence of antigliadin and antiendomysial antibodies indicates a gluten-related disorder, necessitating avoidance of gluten-containing grains, not sweet potatoes.
Choice B rationale
Wheat bread contains gluten, a protein complex found in wheat, barley, and rye. Antigliadin and antiendomysial antibodies are serological markers for celiac disease, an autoimmune disorder triggered by gluten ingestion, leading to small intestinal damage. Therefore, individuals with these antibodies must avoid gluten-containing foods like wheat bread to prevent symptomatic flares and intestinal damage.
Choice C rationale
Orange juice is a gluten-free beverage, primarily composed of water, sugars, and vitamins. It does not contain any gluten-derived proteins. Its consumption is safe for individuals with celiac disease or gluten sensitivity, as it will not elicit an immune response or contribute to intestinal damage in those with antigliadin and antiendomysial antibodies.
Choice D rationale
Swiss cheese is a dairy product and naturally gluten-free. It consists primarily of milk proteins, fats, and calcium, with no gluten-containing grains. Individuals with celiac disease or gluten sensitivity can safely consume Swiss cheese without triggering an immune response, as it does not contain the specific proteins that activate antigliadin and antiendomysial antibodies.
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